Objective: To evaluate the effectiveness of supervised cardiac rehabilitation for conservative chronic kidney disease（CKD）. Method: We surveyed 35 patients with renal dysfunction who completed 5 months of a cardiac rehabilitation program. We compared changes in eGFR, oxygen consumption, 6-minute walking distance, and grip strength at the beginning and end of cardiac rehabilitation programs. And so, we examined the related factors of eGFR change. Results: Oxygen consumption, 6-minute walking distance, grip strength and eGFR after 5 months of the program were significantly improved（oxygen consumption: 10.2 ± 1.7→12.0 ml/min/kg, 6-minute walking distance: 387.9 ± 74.2→427.8 ± 84.3 m，grip strength: 29.6 ± 7.6→31.7 ± 7.2 kg, eGFR: 48.2 ± 10.2→50.5 ± 12.8 ml/min/1.73 m²）. After 5 months of the program, 23 patients（65.7%）were improved in the renal function. The factors related to eGFR improvement were high eGFR and grip strength before the 5-month program and diet adherence in this period. Conclusion: The renal function of CKD patients might be improved by comprehensive cardiac rehabilitation. We recommend strict nutrition management and early exercise therapy for CKD patients.

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The major shortcoming of midCABG （minimally invasive direct coronary artery bypass grafting） lies in its limitation of target vessels and exposure, and hence is uncommonly performed. However, owing to its minimally invasive nature, it is becoming an attractive option in recent years particularly in the setting of hybrid coronary revascularization strategies where accompanying percutaneous coronary interventions （PCI） are conducted. This is a case report of an 82-year-old male who, six months prior to surgical intervention, suffered an acute myocardial infarction and underwent an emergency PCI to his left anterior descending artery. On follow-up coronary evaluation, he was found to have a 99% occlusion of his proximal left anterior descending artery. Given his age, functional status, and extent of coronary disease, he was scheduled for a midCABG. Upon the minimally invasive thoracotomy, his target coronary artery was found to be heavily calcified and was deemed unfit for a traditional anastomosis. Instead, a coronary endarterectomy was undertaken and an interposed saphenous vein graft on-lay patch was sewn to bridge the arteriotomy and mammary graft, allowing for the planned revascularization without conversion to a median sternotomy.

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